Spinal Cord Injury Facts and Figures at a Glance
www.uab.edu/nscisc
February 2013
This is a publication of the National Spinal Cord Injury Statistical Center, Birmingham, Alabama.
Incidence: It is estimated that the annual incidence of spinal
cord injury (SCI), not including those who die at the scene of
the accident, is approximately 40 cases per million population in
the U. S. or approximately 12,000 new cases each year. Since
there have not been any incidence studies of SCI in the U.S.
since the 1990's it is not known if incidence has changed in
recent years.
Prevalence: The number of people in the United States who
are alive in 2013 who have SCI has been estimated to be
approximately 273,000 persons, with a range of 238,000 to
332,000 persons. Note: Incidence and prevalence statistics are
estimates obtained from several studies. These statistics are not
derived from the National SCI Database.
SCI is falls, followed by acts of violence (primarily gunshot
wounds).
The proportion of injuries that are due to sports has decreased
over time while the proportion of injuries due to falls has
increased. Violence caused 13.3% of spinal cord injuries prior
to 1980, and peaked between 1990 and 1999 at 24.8% before
declining to only 14.3% since 2010.
CAUSES OF SCI SINCE 2010
The National Spinal Cord Injury Database has been in
existence since 1973 and captures data from an estimated 13%
of new SCI cases in the U.S. Since its inception, 28 federally
funded SCI Model Systems have contributed data to the
National SCI Database. As of December 2012, the database
contained information on 29,096 persons who sustained
traumatic spinal cord injuries. All the remaining statistics on
this sheet are derived from this database or from collaborative
studies conducted by the model systems. Detailed discussions
of all topics on this sheet may be found in special issues of the
journal Archives of Physical Medicine and Rehabilitation
published in November 1999, November 2004, and March 2011.
Age at injury: SCI primarily affects young adults. Nearly half
of all injuries occurred between the ages of 16 and 30. From
1973 to 1979, the average age at injury was 28.7 years. As the
median age of the general population of the United States has
increased by approximately 9 years since the mid-1970, the
average age at injury has also steadily increased over time.
Since 2010, the average age at injury is 42.6 years. Other
possible reasons for the observed trend toward older age at
injury might include changes in either referral patterns to model
systems, the locations of model systems, survival rates of older
persons at the scene of the accident, or age-specific incidence
rates.
Gender: Overall, 80.7% of spinal cord injuries reported to the
national database have occurred among males. Over the
history of the database, there has been a slight trend toward a
decreasing percentage of males. Prior to 1980, 81.8% of new
spinal cord injuries occurred among males.
Race/Ethnicity:
A significant trend over time has been
observed in the racial/ethnic distribution of persons in the
database. Among persons injured between 1973 and 1979,
76.8% were Caucasian, 14.2% were African American, 1.9%
were Native American and 0.9% were Asian. However, among
those injured since 2010, 67.0% are Caucasian, 24.4% are
African American, 0.8% are Native American and 2.1% are
Asian. Hispanic origin increased from 5.9% in 1970’s to 12.5%
in 2000-2004 and 7.9% since 2010. This trend is due in part to
trends in the United States general population and also possibly
explained by the changing locations of model systems, referral
patterns to model systems, or race-specific incidence rates.
Etiology:
Since 2010, motor vehicle crashes account for
36.5% of reported SCI cases. The next most common cause of
Neurologic level and extent of lesion: Persons with
tetraplegia have sustained injuries to one of the eight cervical
segments of the spinal cord; those with paraplegia have lesions
in the thoracic, lumbar, or sacral regions of the spinal cord.
Since 2010, the most frequent neurologic category at discharge
of persons reported to the database is incomplete tetraplegia
(40.6%), followed by incomplete paraplegia (18.7%), complete
paraplegia (18.0%) and complete tetraplegia (11.6%). Less
than 1% of persons experienced complete neurologic recovery
by hospital discharge. Over the last 20 years, the percentage of
persons with incomplete tetraplegia has increased while
complete paraplegia and complete tetraplegia have decreased.
Occupational status: More than half (57.1%) of those
persons with SCI admitted to a model system reported being
employed at the time of their injury. At one year after injury,
11.8% of persons with SCI are employed. By 20 years postinjury, 34.9% are employed and a similar level of employment
is observed through post-injury year 35.
Residence: Overall, 87.1% of all persons with SCI who are
discharged from the system are sent to a private, noninstitutional residence (in most cases their homes before injury).
Only 6.5% are discharged to nursing homes. The remaining are
discharged to hospitals, group living situations or other
destinations.
Marital status: Considering the youthful age of most persons
with SCI, it is not surprising that most (51.6%) are single when
injured. Among those who were married at the time of injury,
as well as those who marry after injury, the likelihood of their
marriage remaining intact is slightly lower when compared to
the general population. The likelihood of getting married after
injury is also reduced.
Length of stay: Overall, median days hospitalized in the
acute care medical/surgical unit for those who enter a model
system immediately following injury has declined from 24 days
between 1973 and 1979 to 11 days since 2010. Substantial
downward trends are noted for days in the rehab unit (from 98
to 36 days). Overall, median days hospitalized (during acute
care and rehab) were greater for persons with neurologically
complete injuries.
Lifetime costs: The average yearly health care and living expenses and the estimated lifetime costs that are directly attributable to
SCI vary greatly according to severity of injury. These figures do not include any indirect costs such as losses in wages, fringe benefits
and productivity which average $70,575 per year in February 2013 dollars, but vary substantially based on education, severity of
injury and pre-injury employment history.
Average Yearly Expenses
(in February 2013dollars)
Severity of Injury
Estimated Lifetime Costs by
Age At Injury (discounted at 2%)
First Year
Each Subsequent
Year
25 years
old
50 years
old
High Tetraplegia (C1-C4) AIS ABC
$1,044,197
$181,328
$4,633,137
$2,546,294
Low Tetraplegia (C5-C8) AIS ABC
$754,524
$111,237
$3,385,259
$2,082,237
Paraplegia AIS ABC
$508,904
$67,415
$2,265,584
$1,486,835
Incomplete Motor Functional at Any Level AIS D
$340,787
$41,393
$1,547,858
$1,092,521
Data Source: Economic Impact of SCI published in the journal Topics in Spinal Cord Injury Rehabilitation Volume 16 Number 4 in 2011.
Life expectancy is the average remaining years of life for an individual. Life expectancies for persons with SCI are still significantly
below life expectancies for those with no SCI and have not improved since the 1980’s. Mortality rates are significantly higher during
the first year after injury than during subsequent years, particularly for severely injured persons.
Age
at
Injury
20
No SCI
59.0
Life expectancy (years) for post-injury by severity of injury and age at injury
For persons who survive the first 24 hours
For persons surviving at least 1 year post-injury
AIS D - Motor
Low
High
Ventilator AIS D - Motor
Low
High
Ventilator
Functional at
Tetra
Tetra Dependent- Functional at
Tetra
Tetra DependentAny Level
Para (C5-C8) (C1-C4) Any Level
Any Level
Para (C5-C8) (C1-C4) Any Level
52.0
44.6
39.6
35.3
18.6
52.4
45.1
40.4
36.6
24.9
40
40.0
33.7
27.2
23.1
19.7
8.4
34.0
27.7
23.7
20.7
12.3
60
22.7
17.5
12.7
9.9
7.8
2.0
17.7
13.0
10.3
8.4
3.7
Cause of death: In years past, the leading cause of death among persons with SCI was renal failure. Today, however, significant
advances in urologic management have resulted in dramatic shifts in the leading causes of death. Persons enrolled in the National
SCI Database since its inception in 1973 have now been followed for 40 years after injury. During that time, the causes of death that
appear to have the greatest impact on reduced life expectancy for this population are pneumonia and septicemia.
Find additional information in the Annual Report on the NSCISC website: https://www.nscisc.uab.edu/reports.aspx
Presently, there are 14 systems and 5 Form II centers sponsored by the National Institute on Disability and Rehabilitation Research,
Office of Special Education and Rehabilitative Services, U.S. Department of Education
SCI MODEL SYSTEM CENTERS
FORM II CENTERS Collect follow-up data only
Santa
Clara Valley Medical Center
Univ of AL-B’ham Spain Rehab SCIMS
New England Regional SCI Center
San Jose, CA (408) 885-2383
Birmingham, AL (205) 934-3283
Boston, MA (617) 638-7380
So California SCIMS at Rancho Los Amigos
Downey, CA (562) 401-8111
Spaulding-Harvard SCI System
Boston, MA (617) 573-2754
Mount Sinai School of Medicine
New York, NY (212) 659-9340
Rocky Mountain Regional SCI System
Englewood, CO (303) 789-8306
Univ of Michigan SCI Model System
Ann Arbor, MI (734) 763-0971
Institute for Rehabilitation and Research
Houston, TX (713) 797-5972
South Florida SCIMS
Miami, FL (305) 243-9516
Northern New Jersey SCI System
West Orange, NJ (973) 243-6973
Univ of Missouri
Columbia, MO (collected by UAB (205) 934-3283)
Southeastern Regional SCIMS at Shepherd
Atlanta, GA (404) 352-2020
Regional SCI Center of the Delaware Valley
Philadelphia, PA (215) 955-6579
Woodrow Wilson Rehab Center
Fishersville, VA (collected by UAB (205) 934-3283)
Midwest Regional SCI Care System
Chicago, IL (312) 238-6207
U of Pittsburgh Model System on SCI
Pittsburgh, PA (412) 232-7949
Kentucky Regional Model SCI System
Louisville KY (502) 582-7443
Northwest Regional SCI System
Seattle, WA (800) 366-5643
This is a publication of the National Spinal Cord Injury Statistical Center, Birmingham, Alabama, which is funded by the National Institute on Disability and Rehabilitation Research
(grant #H133A110002), Office of Special Education and Rehabilitative Services, U.S. Department of Education, Washington, DC. The opinions contained in this publication are those
of the grantee and do not necessarily reflect those of the U.S. Department of Education. ©2012, Board of Trustees, University of Alabama
Suggested Citation: National Spinal Cord Injury Statistical Center, Facts and Figures At a Glance. Birmingham, AL: University of Alabama at Birmingham, March 2013.
The National SCI Statistical Center 1717 6th Avenue South, SRC 515, Birmingham, AL 35233-7330
For Statistics: (205) 934-3342; For Business: (205) 934-3320; TDD: (205) 934-4642; FAX: (205) 934-2709; E-mail: NSCISC@uab.edu